Description of the programme

The Money and Pensions Service (MaPS) is responsible for delivering free and impartial information and advice on debt to consumers in England. Government introduced ‘Breathing Space’ regulations in England and Wales 2021 to give customers in problem debt ‘standard breathing space’ legal protections from creditor action for up to 60 days. A ‘mental health breathing space’ (MHCBS) is an extension of the ‘standard breathing space’ for people receiving mental health crisis treatment which lasts as long as that treatment lasts plus 30 days.

The pilot launched in England and Wales in May 2021 when the regulations came into force. The particular delivery model piloted by Money and Pensions Service for MHCBS involved MaPS hosting a website to receive all MHCBS applications and appointing an organisation (Rethink in England, Citizens Advice Cymru in Wales) to manage those applications:

• Referral to the MHCBS is made by the customer or their personal or professional representative (such as a social worker, or Approved Mental Health Professional - AMHP).
• During referral, the receipt of crisis treatment is confirmed by an AMHP and the collation of evidence is supported by a Nominated Point of Contact (NPOC).
• Referrals are then processed by Rethink (in England) who formally log the customer, who enters the MHCBS and receives protections (any creditor action and contacts are paused, and most interest and charges on their debts are frozen).
• Rethink offer specialist phone and online debt advice and signposting to other organisations throughout the process, including for ineligible MHCBS applicants.

In the first year, 1,099 customers were referred to the MHCBS in England (the evaluation covered England only).

The study

The process and outcome evaluation was undertaken, in England, between May 2021 and May 2022 to coincide with the first year of delivery of the programme. It was commissioned by MaPS and sought to address four objectives:

• Document implementation of the pilot.
• Understand the experiences of programme clients.
• Measure and explain client outcomes.
• Inform and make recommendations for longer-term design of the MHCBS.

The evaluation used a theory-based approach which combined:

• a scoping and set-up phase (rapid evidence review, 11 stakeholder interviews and development of a theory of change and evaluation framework);
• qualitative data collection across two waves (22 interviews with MHCBS clients or their family members, and a range of interviews and focus groups with AMHPs, NPOCs, Rethink staff, metal health stakeholders and creditors); and
• secondary analysis of quantitative data (management information provided by Rethink for 1,099 clients).

Key findings

• The client journey was delivered largely according to design with some exceptions (notably that debt advice was offered throughout the process rather than after clients had left the MHCBS as originally intended).
  • Actual demand for MHCBS (1,099 over 12 months) was lower than forecasted demand (6,300 over 10 months). This was mainly attributed to low awareness and knowledge of MHCBS among health professionals, and awareness-raising needed to be ongoing to be most effective
  • The median time taken to process applications was 51 minutes and most applicants went onto enter MHCBS (84%).
  • Entry to MHCBS was within 24 hours of referral in 84% of cases and MHCBS clients spent an average of 3.9 months in a MHCBS.
  • 32% of MHCBS clients engaged with debt advice.
  • AMHPs were often hard to find or engage in the referral process.
• Client experiences of MHCBS were largely positive, although a key challenge was the continued action of creditors while clients were in a MHCBS.
  • Many found it difficult to engage with debt advice because of their mental health. Importantly, this impacted on the ability of MHCBS to deliver good mid-term outcomes for clients.
• The study found greater client awareness of the options open to them.
  • In the short-term, a freeze on debt accrual, a reduction in creditor action and feeling less stressed supported clients’ mental health.
  • In the mid-term, clients spoke positively about how their MHCBS had prevented their debt worsening which in turn supported mental health recovery.
  • Rethink staff and clients were pleased about the range of debt solutions available. 30% of clients who had started debt advice had already had one debt advice outcome, including 14% whose debts were reduced, renegotiated or written off.
• The high priorities identified were to: monitor and improve rates of engagement with debt advice; and coordinate communication across stakeholders.

Points to consider

• The authors note that there were some problems with the accuracy of the Management Information data due to limitations in the level of detail it was possible to record for the purposes of the evaluation.
  • The authors note most clients were still in an ongoing MHCBS when the quantitative data were analysed which will affect some of the metrics.
• The authors note that the number of individuals and organisations interviewed for the evaluation was comparatively small and that this might limit how well the results represent or generalise to all those involved in the pilot.
  • Some elements of the implementation of the pilot were negatively impacted by the Covid-19 pandemic.
• The report is likely to be relevant to funders and organisations involved in debt advice delivery, especially stakeholders with an interest in or involvement with people in mental health crisis.
  • The outcomes were not a primary focus of the report and were largely measured through qualitative research.
  • The report describes some outcomes for professionals but notes that these were not a primary focus in the current study.
• Although the study relates to regulation that is specific to the provision of debt advice in England and Wales, lessons from the process evaluation (particularly around implementation) are likely to apply well beyond the specific policy and geographical boundaries of the pilot